Efficacy and Safety of the Modified EPOCH Regimen (Etoposide, Vincristine, Doxorubicin, Carboplatin, and Prednisolone) for Adult T-cell Leukemia/Lymphoma: A Multicenter Retrospective Study.

Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols / pharmacology Cyclophosphamide / pharmacology Doxorubicin / pharmacology Etoposide / pharmacology Female Humans Leukemia-Lymphoma, Adult T-Cell / drug therapy Male Middle Aged Prednisone / pharmacology Progression-Free Survival Retrospective Studies Vincristine / pharmacology

Adult T-cell leukemia/lymphoma Allogeneic hematopoietic stem cell transplantation Carboplatin Human T-lymphotropic virus type I modified EPOCH

Journal

Clinical lymphoma, myeloma & leukemia

ISSN: 2152-2669

Titre abrégé: Clin Lymphoma Myeloma Leuk

Pays: United States

ID NLM: 101525386

Informations de publication

Date de publication:
07 2020

Historique:

received: 26 01 2020

revised: 12 03 2020

accepted: 14 03 2020

pubmed: 22 4 2020

medline: 26 8 2021

entrez: 22 4 2020

Statut: ppublish

Résumé

We retrospectively analyzed patients with untreated aggressive adult T-cell leukemia/lymphoma who received the modified EPOCH (mEPOCH) regimen. Patients received up to 6 mEPOCH cycles. Etoposide (50 mg/m In 103 patients, overall response rate and complete response rate were 58% and 25%, respectively. With a median follow-up of 8.9 months, the median survival time was 9.8 months (95% confidence interval, 7.2-13.9 months). The median progression-free survival (PFS) was 4.2 months (95% confidence interval, 3.4-5.7 months). Patients who completed ≥ 4 cycles experienced significantly better overall survival and PFS compared with those who completed < 4 cycles. Twenty-eight patients underwent allogeneic hematopoietic stem cell transplantation after mEPOCH and demonstrated significantly prolonged overall survival and PFS compared with those who did not undergo transplantation. The mEPOCH regimen is effective with tolerable adverse effects and may be an alternative treatment option for adult T-cell leukemia/lymphoma.

Sections du résumé

BACKGROUND

We retrospectively analyzed patients with untreated aggressive adult T-cell leukemia/lymphoma who received the modified EPOCH (mEPOCH) regimen.

PATIENTS AND METHODS

Patients received up to 6 mEPOCH cycles. Etoposide (50 mg/m

RESULTS

In 103 patients, overall response rate and complete response rate were 58% and 25%, respectively. With a median follow-up of 8.9 months, the median survival time was 9.8 months (95% confidence interval, 7.2-13.9 months). The median progression-free survival (PFS) was 4.2 months (95% confidence interval, 3.4-5.7 months). Patients who completed ≥ 4 cycles experienced significantly better overall survival and PFS compared with those who completed < 4 cycles. Twenty-eight patients underwent allogeneic hematopoietic stem cell transplantation after mEPOCH and demonstrated significantly prolonged overall survival and PFS compared with those who did not undergo transplantation.

CONCLUSION

The mEPOCH regimen is effective with tolerable adverse effects and may be an alternative treatment option for adult T-cell leukemia/lymphoma.

Identifiants

DOI: 10.1016/j.clml.2020.03.008 PMID: 32312633

pubmed: 32312633

pii: S2152-2650(20)30141-5

doi: 10.1016/j.clml.2020.03.008

pii:

doi:

Substances chimiques

Vincristine 5J49Q6B70F

Etoposide 6PLQ3CP4P3

Doxorubicin 80168379AG

Cyclophosphamide 8N3DW7272P

Prednisone VB0R961HZT

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

e445-e453